The proposed East African Center of Excellence in Health Informatics will be a major resource for improving local human capacity for health informatics and eHealth research in sub-Saharan Africa. It will be built upon the existing 19-year collaboration between Indiana University and Moi University in Eldoret, Kenya. This collaboration has launched AMPATH, one of sub-Saharan African's largest and most successful health care programs. It is served by the AMPATH Medical Record System which contains more than 2 million records for more then 200,000 HIV/AIDS and primary care patients receiving care through AMPATH and Ministry of Health facilities that host AMPATH clinics. Built upon the efforts from the initial Fogarty ITMI program, the AMRS is an open-source electronic health record (EHR) that spawned OpenMRS, a free open- source EHR that is now the most widely adoped EHR in the developing world. To increase the local health informatics capacity, we will re-instate the post-doctoral Regenstrief-Moi Biomedical Informatics Fellowship Program in partnership with the Regenstrief Institute. Fellows will spend 1-2 years in Indianapolis a) participating fully in Regenstrief s NLM-funded informatics fellowship program and b) completing the coursework for a MS in either Clinical Research (through the Indiana CTSI) or Health Informatics (through the Indiana University School of Informatics). They will spend their last fellowship year in Eldoret, Kenya developing, implementing, and studying the effects of an informatics tool or intervention. We will also establish 2-week Short Courses at the AMPATH Training Institute in Eldoret, Kenya that will implement a competency-based health informatics curriculum for programmers/developers, data managers/analysts, clinical and health services researchers, and health care managers in East Africa to increase local capacity for using health informatics tools and interventions to improve the quality and efficiency of care. We will also implement a 2 to 12-week Mentored Practicums for East African faculty and staff to work hand-in-hand with AMRS developers/programmers, data managers/analysts, and researchers to learn practical aspects of developing, implementing, and supporting eHealth tools to enhance research. RELEVANCE (See instructions): Health care and public health are information enterprises. To be most efficient and effective, health care delivery and public health research and interventions require timely access to high-quality data. To date, developing countries have been on the far side of the "digital divide" and hence have obtained less than optimal outcomes from whatever funds they have to spend on health. Implementing electronic data capture and manaaemfint in East Africa will anhance the nutcnme.s of health rare and nuhlic health intfirventinns.